Background: To evaluate the prevalence and risk factors associated with myopia and high myopia in children in South Korea. Methods: A total of 983 children 5–18 years of age who participated in the Korean National Health and Nutrition Examination Survey 2016–2017 (KNHANES VII), a nationwide population-based cross-sectional study, were evaluated. Myopia and high myopia were defined as a spherical equivalent (SE) ≤ − 0.5 diopters (D) and SE ≤ --6.0 D. The association between refractive errors and potential risk factors for myopia was analyzed. Results: The prevalence of myopia and high myopia was 65.4 and 6.9%, respectively. Older age and parental myopia were significantly associated with both myopia and high myopia, while higher body mass index (BMI) was associated with high myopia only. Although the proportion of subjects who spent more time on near work activities (≥4 h/day) was sequentially increased with increased refractive error, this tendency was not statistically significant by multivariable logistic regression. Conclusions: Korean children had a high prevalence of myopia and high myopia. In this age group, the risk of myopia increased with aging and parental myopia. Higher BMI may be associated with high myopia.

Dry eye syndrome related to radiation therapy is relatively common and can severely impair a patient’s daily life. The nuclear factor of activated T cells 5(NFAT5) is well known for its osmoprotective effect under hyperosmolar conditions, and it also has immune-modulating functions. We investigated the role of NFAT5 and the protective effect of α-lipoic acid(ALA) on radiation-induced lacrimal gland (LG) injuries. Rats were assigned to control, ALA only, radiation only, and ALA administered prior to irradiation groups. The head and neck area, including the LG, was evenly irradiated with 2 Gy/minute using a photon 6-MV linear accelerator. NFAT5 expression was enhanced and localized in the LG tissue after irradiation and was related to cellular apoptosis. ALA had a protective effect on radiation-induced LG injury through the inhibition of NFAT5 expression and NFAT5-dependent signaling pathways. Functional radiation–induced damage of the LG and cornea was also restored with ALA treatment. NFAT5 expression and its dependent signaling pathways were deeply related to radiation-induced dry eye, and the condition was improved by ALA treatment. Our results suggest a potential role of NFAT5 and NF-κB in the proinflammatory effect in LGs and cornea, which offers a target for new therapies to treat dry eye syndrome.

Purpose: Binocular diplopia is a primary complication that may arise after scleral buckling surgery in patients with rhegmatogenous retinal detachment. This study examined the incidence of and risk factors for binocular diplopia after scleral buckling surgery; it also evaluated the rate of strabismus surgery success in patients with diplopia. Methods: Medical records of 417 patients who underwent scleral buckling surgery for rhegmatogenous retinal detachment at a single institution from January 2017 to June 2022 were retrospectively reviewed. Patients who experienced binocular diplopia for > 6 months were included in the diplopia group. Results: After surgery, 22 patients (5.3%) developed binocular diplopia. There were no significant correlations of diplopia onset with buckle position (i.e., the affected muscle), cryophotocoagulation, subretinal fluid drainage, and the use of gas or oil injections. Prism therapy restored binocular single vision in three patients. Ten patients chose to undergo strabismus surgery, and one patient underwent encircling band removal. All strabismus surgery patients displayed adhesion between the buckle and extraocular muscle. After surgery, 60% of these patients regained binocular single vision. Conclusions: Clear risk factors leading to ocular movement disorders and diplopia after scleral buckling remain undefined. If diplopia persists despite prism-based conservative treatment, strabismus surgery may offer relief.

Purpose: To report a biopsy-proven case of granulomatosis with polyangiitis (GPA) who visited for red eye and discomfort. We detected papillary thyroid cancer by a whole-body scan. Case summary: A 56-year-old female presented to our clinic with hyperemia and discomfort in the right eye for the past 1 month. The visual acuity was 0.9 in the right eye. Congestion and chemosis of the right conjunctiva were observed by slit-lamp microscopy. There was a firm, erythematous, tender mass near the right nasolacrimal duct. Impairment of adduction and infraduction and proptosis were observed. Radiologically, a 3.6 × 2.6 × 1.2 cm right orbital mass was seen in the intraorbital extraconal space, invading the right nasolacrimal duct and nasal cavity. Pathologic and supplementary investigations showed granulomatous, c-anti-neutrophil cytoplasmic antibodies (ANCA)-positive inflammation in the mass. The patient was diagnosed with GPA. Whole-body computed tomography and positron emission tomography-computed tomography revealed multiple lesions in the right orbit, nasal cavity, mediastinum, retropubic area, and left thyroid gland. Thyroid ultrasonography and biopsy led to a diagnosis of papillary carcinoma with lymph node metastasis. Topical and systemic steroids and rituximab injection were administered, and total thyroidectomy with bilateral central lymph node dissection was performed. This led to improvements in proptosis and limitation of extraocular movement. Conclusions: GPA is a rare disease that may initially present with ocular symptoms. It can be associated with malignancies even in the absence of immunosuppression. Patients with ocular problems suspected of having GPA should undergo autoimmune antibody testing, including ANCA and tissue biopsy.

Background/Objectives: To determine the clinical features of different types of intermittent exotropia according to the distance and near angles of exodeviation. Methods: This study included 5331 patients with intermittent exotropia. The patients were divided into three groups according to the near-distance differences in their exodeviations: (1) Basic-type: difference between distant and near angles of the exodeviation < 10 prism diopters (PD); (2) Convergence insufficiency (CI)-type: near-distance angle ≥ 10 PD; (3) Divergence excess (DE)-type: distance-near angle ≥ 10 PD. The main outcome measures were demographics, clinical characteristics of exotropia, subjective symptoms, medical history, and family history. Results: Overall, 4599 (86.2%) patients had basic-type exotropia, 500 (9.4%) had CI-type, and 232 (4.4%) had DE-type exotropia. Older age and greater magnitude of myopia were associated with CI-type exotropia. A-pattern exotropia, superior oblique (SO) overaction, good fusional control, good stereoacuity, and diplopia were most common in CI-type exotropia. SO underaction and photophobia were most frequently observed in DE-type exotropia compared to the other types. Conclusions: The clinical characteristics varied among the different types of intermittent exotropia. CI-type exotropia was most frequently associated with older age and greater myopia. DE-type exotropia was associated with frequent photophobia.